IMPACT OF MEDICAL-STUDENT TEACHING ON FAMILY PHYSICIANS USE OF TIME

Background. The purpose of this study was to determine how much and in what ways family physicians' time at work is affected by the presence of a medical student in the practice. Methods. The study included wor k sampling of 22 nonacademic family physicians, each observed during 1 day with and 1 day without a medical student, and 12 academic family physicians, of whom nine were observed for 8 half-days and three for 2 or 4 half-days of clinical practice. Observations were made on averag e every 4 minutes at preselected random times during the workday. Resu lts. When a student was present at the practice, the amount of time pr ivate physicians actually spent working increased by 52 minutes per da y, and their patient-care productivity decreased from 3.9 to 3.3 patie nts per hour. There was no significant change in time spent at work fo r academic physicians. With a student present, the physicians in priva te practice spent 27 fewer minutes per day in patient-care activities, whereas academic physicians spent 47.5 fewer minutes per day in these activities. Private and academic physicians spent 71 and 63 minutes p er day, respectively, in student-centered activities. There were few d ifferences bens een physician groups in how this direct teaching time was used. Conclusions. when a student is in the practice, private fami ly physicians shift substantial amounts of work time from patient-cent ered to student-centered activities. They also use their personal time for teaching activities and experience a decrease in patient-care pro ductivity of 0.6 patients per hour.